Treatment of microvascular angina: the need for precision medicine

Patients with chest pain symptoms thought to be caused by myocardial ischaemia, no obstructive coronary artery disease (no stenosis >50% in epicardial coronary arteries), and evidence of coronary microvascular dysfunction (invasive CFR to adenosine <2.5, no dilatation in response to acetylcholine, or MPRI <2.0 at pharmacological CMRI stress test).

Ranolazine 500 mg twice a day (possibly increased to 1 g twice a day) for 2 weeks.

Placebo for 2 weeks (crossover design).

Seattle angina questionnaire (SAQ) scores and angina episodes or nitroglycerin use.patient reported